WELLSTAR HEALTHCARE SYSTEM (NPI# 1275879595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275879595 |
| Entity Type | Organization |
| Organization Name | WELLSTAR HEALTHCARE SYSTEM |
| Other Organization Name | WELLSTAR HEALTH VENTURES |
| Practice Address |
818 Church St Ne Marietta GA 30060-8969 |
| Mailing Address |
805 Sandy Plains Rd Attention: Revenue Management Marietta GA 30066-6340 |
| Practice Telephone | 7707925284 |
| Practice Fax Number | 7707921513 |
| Mailing Telephone | 7707925284 |
| Mailing Fax Number | 7707921513 |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2012-12-13 |
| Authorized Official Name | TAMMY M BENNETT (REVENUE MANAGEMENT) |
| Authorized Official Telephone | 7707925284 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
PT007517 | GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| WellStar Health Ventures | Doing Business As Name - Organization |
| Street Address |
818 CHURCH ST NE |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-8969 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326038472 | Harry T Harvin | Obstetrics & Gynecology | 818 Church St Ne, Marietta, GA 30060-8969 | 2005-10-28 |
| 1679819197 | Gregory Thomas Scanlan | Clinic/Center | 818 Church St Ne, Marietta, GA 30060-8969 | 2013-01-03 |
| 1760728299 | Holly Goldin | Physical Therapist | 818 Church St Ne, Marietta, GA 30060-8969 | 2013-01-03 |
| 1295071272 | Meredith Brunson | Occupational Therapist | 818 Church St Ne, Marietta, GA 30060-8969 | 2012-12-20 |
| 1093051070 | Katherine Gavin | Physical Therapist | 818 Church St Ne, Marietta, GA 30060-8969 | 2012-12-20 |
| 1184960163 | Amy Barfield | Occupational Therapist | 818 Church St Ne, Marietta, GA 30060-8969 | 2012-12-20 |
| 1841536091 | Elizabeth Parker | Occupational Therapist | 818 Church St Ne, Marietta, GA 30060-8969 | 2012-12-17 |
| 1023354354 | Christopher Howren | Physical Therapist | 818 Church St Ne, Marietta, GA 30060-8969 | 2012-12-13 |
| 1447535521 | Caroline B Fabian | Physical Therapist | 818 Church St Ne, Marietta, Marietta, GA 30060-8969 | 2011-10-20 |
| 1174539571 | Nancy Earle Sherrington | Physical Therapist | 818 Church St Ne, Marietta, GA 30060-8969 | 2006-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114423829 | Pivot Point Counseling Services | Clinic/Center | 3225 Shallowford Rd Ste 710, Marietta, GA 30062-7026 | 2018-04-02 |
| 1922642644 | Therapeutic Allies | Clinic/Center | 540 Powder Springs St Ste C17, Marietta, GA 30064-3561 | 2019-11-06 |
| 1598216061 | Marietta Counseling | Clinic/Center | 2440 Sandy Plains Rd, Bldg #25, Marietta, GA 30066-7217 | 2016-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306451265 | Chrystal Care | Clinic/Center | 3206 Stratford Cir, Morrow, GA 30260-8111 | 2020-09-08 |
| 1114536372 | The Mindful Match, LLC | Clinic/Center | 528b Angier Ave Ne, Atlanta, GA 30308-2902 | 2020-07-23 |
| 1427666817 | Atlanta Child and Family Therapy, LLC | Clinic/Center | 2144 Kodiak Dr Ne, Atlanta, GA 30345-4150 | 2020-07-21 |
| 1407474778 | Your Way Out, LLC | Clinic/Center | 2330 Scenic Hwy S Ste 316, Snellville, GA 30078-3115 | 2020-07-13 |
| 1073141271 | Monte Nido Georgia LLC | Clinic/Center | 126 Johnson Ferry Road Ne, Sandy Springs, GA 30328-3004 | 2020-04-01 |
| 1700418142 | Behavior Therapy Solutions LLC | Clinic/Center | 4744 N Royal Atlanta Dr Ste A, Tucker, GA 30084-3820 | 2020-02-04 |
| 1730721036 | Brown Professional Counseling & Consultation Services, LLC | Clinic/Center | 1105 Russell Pkwy Ste 2, Warner Robins, GA 31088-5586 | 2019-10-09 |
| 1184182115 | Pathways To Recovery Associates Inc. | Clinic/Center | 7210 Church St, Riverdale, GA 30274-2918 | 2019-03-08 |
| 1336614254 | Learn & Grow Family Counseling, LLC | Clinic/Center | 327 Dahlonega St Ste 402, Cumming, GA 30040-2486 | 2018-10-07 |
| 1790271633 | Jill Elizabeth Gresham | Clinic/Center | 750 Hammond Dr Ste 100, Atlanta, GA 30328-5532 | 2018-07-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.